Archive November 2014 XV, No. 11

Focusing on Success in Retinal Surgery

4 keys to capitalizing on the specialty's rapidly changing nature.

Pravin Dugel, MD


retinal surgeons EYES WIDE OPEN With technology evolving rapidly, retinal surgeons have to have the discipline to keep learning every day.

There's a revolution underway in retinal surgery. In a very short period of time, a 20-gauge surgery that required sutures and often general anesthesia has become a 25- or 27-gauge surgery that's suture-less and usually done under local anesthesia. Our new techniques are far superior. We've improved efficiency, we've improved safety and we've improved outcomes. And these huge leaps forward are just the beginning. The field is going to be advancing even faster over the next few years. To take full advantage of the rapid pace of improvement, you'll need to understand these 4 key components of a successful vitreo-retinal surgical practice.

1 Have the right surgeons with the right attitude. The surgeons you choose are ultimately going to determine the success or failure of the center. Technical skill isn't enough. There are some very good surgeons who still haven't adapted and adopted new techniques. Retinal surgeons have to be completely open-minded and have the discipline to learn new things every day. That flexibility requires energy, discipline and a willingness to step away from complacency.

There's no denying that speed is an important component of profitability. But with surgeons, it's essential to understand and stress the difference between speed and efficiency. What's most important is having the commitment to provide the best possible care for your patients. Patient care must always be No. 1 and profitability always No. 2. As long as you have those priorities set properly, you'll be on the right track.

2 Take advantage of increasingly precise instruments and better visualization. With small-incision vitreo-retinal surgery, we can use techniques that produce far less trauma and far better outcomes. We have 23- and 25 gauge instruments, and soon we'll have 27-gauge (the 27+ Portfolio, recently introduced by Alcon). Since I prefer to use the smallest gauge available, when the 27+ becomes available, I'll use that for all of my cases. The smaller the wound, the better.

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